LivingWellAZ-Jan.2013

HEALTH-CARENews

I f you want help losing weight througha commercial weight loss program,you can choose from a portion-control

approach where you eat your own food andfind emotional support at public meetingsand/or online (such as Weight Watchers);prepackaged food programs (such as JennyCraig and Nutrisystem); or meal replacementprograms (such as Optifast and Medifast).You can also choose from plans popularizedin books or specialized diets that requiresupplements and/or following a restrictiveregimen, such as the hCG diet.“If you have 20 pounds or less to lose,” saidCraig Primack, M.D., of Scottsdale WeightLoss Center, “Weight Watchers or Jenny Craigis a great choice, depending on whether youwant to prepare meals yourself or you preferthem ready-made. But if you have more than20 pounds to lose, youmay want or need amore intensive program.”

Pre-packagedmealsJenny Craig, like Nutrisystem, offersportion-controlled prepackaged meals. TheJenny Craig program includes one-on-onecounseling; Nutrisystem’s does not. Clientscan obtain Jenny Craig products through aweight loss center or through the mail, whileNutrisystem’s products are available onlyby mail.“These programs are especially goodfor people who don’t like to cook and whostruggle with portion control,” said LisaGalper, Psy.D., a Scottsdale psychologist whospecializes in helping clients get control oftheir weight.

In-person or online supportWeight Watchers is ideal for those whoappreciate an in-person support groupthat promotes accountability, Galper said.“The members and group leader can helpyou adjust when you feel stuck,” she said.“They can help you make the plan moresustainable for your lifestyle.”Weight Watchers also has an onlineprogram for those who are more comfortablewith anonymous sharing or who don’t havetime or transportation to attend in-personmeetings.

Diet decisions, decisions...Picking the right weight loss program depends on your preferencesBY DEBRA GELBART

By The NUMBERS

Continued on page 3DIET DECISIONS

HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILYTHE ARIZONA REPUBLIC A SPECIAL PUBLICATION CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING Vol. 3, No. 1 January 2013HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILYA SPECIAL PUBLICATION CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING Vol.

wellaz-az-

SMALL NUMBERS CAN ADD UP BIG-TIME:

Craig Primack, M.D., of Scottsdale Weight Loss Center, explains some of the options for weight loss, including prepackaged meals,meal replacements and more. Some programs offer online support, while others offer in-person counseling, either one-on-one orin group settings. Whatever the plan, experts agree that accountability is key.

RICKD’ELIA

Flexible SpendingandHealth SavingsAccountsSave money while managingyour healthcare costs

BY JAKE POINIER

As of the beginning of 2012, more than13.5 million Americans were using healthsavings accounts (HSAs), upmore than2million from theprevious year.Meanwhile,more than 85 percent of large employersoffer flexible spending accounts (FSAs).

Pre-tax dollarsBoth account types allow participantsto set aside pre-tax dollars to pay forqualified healthcare expenses, but thereare key differences. HSAs are availableonly to employees enrolled in high-deductible health plans (HDHPs), andunused funds can grow like an investmentaccount. FSAs have a ‘use-it-or-lose-it’provision, meaning unused contributionsare forfeited at the end of the plan year, soemployees shouldmake sure to budgetconservatively.“HSAs not only empower you to

make thoughtful healthcare decisions,there are three tax advantages,” said JeffStelnik, FSA, MAAA, senior vice presidentof strategy, sales andmarketing for BlueCross Blue Shield of Arizona. “First, yourcontributions are pre-tax and reduce yourtaxable income. Second, the investmentsyoumake in the account grow tax-free.Third, withdrawals for qualified expensesare also tax-free.”

Lower contributionsWhile maximum contribution levels riseeach year for HSAs (up to $6,450 for afamily in 2013), rules on FSAs are gettingtighter.“As of January 1, themaximum annual

employee contribution is $2,500,” saidStephanie O’Dell, an account executivewith MJ Insurance. While employees won’tbe able to set aside as much for eligibleexpenses such as braces, contact lenses,prescriptions and dental procedures,O’Dell emphasized the bright side.“If an employee and spouse are both

offered FSAs at their places of work,theymay each elect up to the annualmaximum amount,” she said.

Educated consumersMany carriers offer online cost estimatorsthat allow you to compare differentprocedures, facilities and pharmacies.“HSAs aren’t only for high-income orvery healthy individuals,” Stelnik noted.“They’re for anyone who wants to takecontrol of how their healthcare dollarsget spent.”

IN THIS ISSUE:02: CERVICAL CANCER PREVENTION03: STOPPING BONE LOSS04: SELECTING PROPER FITNESS SHOES04/05: SUPPORT GROUPS, EXPERTS06: HOPE FOR MIGRAINE SUFFERERS

ResourcesIRS: irs.gov/pub/irs-pdf/p502.pdf

Your employer’s benefitsadministrator

Your tax adviser

5 tips to help youstay motivated

1 Eliminate diet“saboteurs”: Keep“red light” foods out ofthe house.

2 Eat fewer carbohydrates:High amounts of carbs eachday (more than 150 grams,or about 600 calories ofcarbs) promote hunger.

3 Record what you eat:Mobile apps such as MyFitness Pal, Lose It andCalorie King help you keeptrack of the foods you eatas well as the amountyou exercise.

4 Getmore sleep: Studieshave shown that amongpeople who sleep five hoursa night or less, 80 percentare overweight.

5 Stay focused: Focus onmaking changes, bothsmall and large, that willaccumulate into a differentlifestyle over the long run.

Source: Department of Health and Human Services,National Heart Blood and Lung Institute; nhlbi.nih.gov/health

EATING JUST 150 CALORIES MORE A DAY THAN YOU BURN

CAN LEAD TO AN EXTRA 5POUNDS OVER 6MONTHS

OR 10POUNDS IN 1YEAR

y

LisaGalper,Psy.D.,specializesinteachingclassesto help people control their weight. Amongother options, smartphone applications helpusers track their progress and stay in control.

—PAULA HUBBS COHEN

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VITAL Signs

test, a test that literally takes seconds in adoctor’s office.

Because cervical cancer is usually veryslow-growing, it’s unlikely that the diseasewould develop between regular Paptests, Wolf said. More commonly, she said,HPV can cause pre-cancerous changesin the cervix, called dysplasia. In mostcases, dysplasia can be easily treated. Leftunmonitored and untreated, dysplasia candevelop into cervical cancer.

Medical community guidelines for thefrequency of Pap tests say this, accordingto Glendale gynecologist Lisa Jaacks, M.D.,of Desert West Obstetrics & Gynecology:if you’re 30 or over and you’ve had threenormal Pap tests in a row, you’re advised tobe screened every three years. Otherwise,you should have a Pap test every year.

Consider vaccinationFor girls and young women (and males,too) between the ages of 9 and 26,prevention of the four most commontypes of HPV comes in the form of avaccine called Gardasil. Although some

Unlike the lottery, here’s a situationwhere the odds are mostly on your

side: cervical cancer is almost entirelypreventable. Even if you do contract it, alocal expert points out, you have morethan a 90 percent chance of survivingat least five more years if it’s treatedin its earliest stage. On the flip side,said Judith Wolf, M.D., a gynecologiconcologist and surgery section chief atBanner MD Anderson Cancer Center inGilbert, if the disease is not diagnoseduntil after it has metastasized, a womanhas only a 25 percent chance of livingfor five more years.

Screening is keyCervical cancer almost always is causedby the sexually transmitted humanpapillomavirus (HPV), which is presentin 80 percent of all women at sometime in their lives. Most cases of HPVdo not turn into cervical cancer and theinfection typically clears on its own,Wolf said. But if changes are occurring,they can be discovered through a Pap

Cervical cancer can be preventedDoctors urge women to get screened regularly BY DEBRA GELBART

Treatment variesTreatment of cervical cancer dependson the extent of the disease, Wingosaid. An early Stage I tumor can betreated with “fertility-sparing excisionof the cervix itself,” she explained. “Ahigher Stage I tumor may require aradical hysterectomy, while patientspresenting with advanced-stage cervicalcancer are treated with radiation andchemotherapy.”

Wingo notes that every patient shehas who is diagnosed with cervicalcancer that requires advanced treatmenthas said “I wish I had just gone to thedoctor sooner.”

controversy exists about the vaccinebecause it’s only been available for aboutsix years, many doctors are adamantabout its importance. “This is a vaccinethat prevents more than HPV — it canprevent cancer,” Jaacks said. It’s nowrecommended for boys and young men aswell, so that they can protect their futuresexual partners from exposure to HPV.

HPV is linked in some cases to penile,anal and oral airway cancers, said ShanaWingo, M.D., a gynecologic oncologistwith Arizona Oncology in Phoenix.“So boys who get the vaccine arenot only protecting themselves fromfuture exposure to genital warts, butmalignancies as well,” Wingo said. “Nowthat there is a vaccine available, I ampassionate about preventing HPV andcancers associated with this virus.”

“Gardasil works best when administeredbefore someone has become sexuallyactive,” Jaacks said. “In our practice, wherehundreds of patients have been vaccinatedwith Gardasil, the only side effect we’veseen is pain at the injection site.”

ResourcesAmerican Cancer Society:cancer.org

Medline Plus:nlm.nih.gov/medlineplus

National Cancer Institute:cancer.gov

THINKSTO

CK

A division of The Arizona Republic.200 E. Van Buren St., Phoenix, AZ 85004

General Manager: CAMI KAISER,[email protected] Creative Development:ISAAC MOYA,[email protected]: PAULA HUBBS COHEN,[email protected]

Look for Livingwell a-z on the first Wednesday of each month!Each month, we bring you local health information you can use to keep you and your family living well. From A to Z,we tackle a broad range of health issues and offer tips for keeping your healthcare costs in check. This publication isproduced by Republic Media Custom Publishing. For questions concerning any content included in this publicationplease contact: Editor Paula Hubbs Cohen, [email protected] or call 602-444-8658.

Contributing Editor: JIM WILLIAMS,[email protected]

Managing Art Director: TRACEY PHALEN,[email protected]

Design: LISA QUIRIN, [email protected]

Republic Media Intern: NICK KOSTENKO

Advertising:RHONDA PRINGLE,602-444-4929,[email protected] general advertising inquiries,contact Republic Media at602-444-8000.

2 | LIVING WELL A-Z | WEDNESDAY, January 2, 2013

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Meal replacementsPrimack said that many of his patients chooseOptifast, a meal replacement program thatfeatures shakes, soups and protein bars andincludes regularly scheduled monitoring bya physician trained and board-certified inobesity medicine. A similar program calledMedifast is administered through a differentorganization with centers around the country.Optifast requires face-to-face medicalsupervision while Medifast clients haveseveral options for support.

“Meal replacement programs workbest when patients gradually beginreintroducing regular food after they’vereached their goal weight,” Primack said.“They may want to consider using at leastone meal replacement a day for monthsafter they reach their goal.”

hCGThe hCG diet is a 500-calorie-a-day dietsupplemented by the pregnancy hormonehuman chorionic gonadotropin (hCG)delivered either by injection or in liquiddrops under the tongue. It is controversial,but healthcare practitioners who make itavailable to patients cite a high percentageof success among patients as an indicationof its effectiveness.

“In our practice, thousands of patients havegone on the hCG diet over the past five years,”said Julia Eastman, L.Ac., D.O.M., a doctor ofOriental medicine and licensed acupuncturistwhose Phoenix practice is led by gynecologistEugenie Anderson, M.D. “We have not seenany adverse side effects and patients areextremely satisfied with their results.”

A different point of view comes fromPrimack, who pointed out that the hCG dietis not approved by the American Societyof Bariatric Physicians and that the FDA hasnot approved the liquid drops as a weightloss agent.

“There is no published peer-reviewedstudy showing that hCG helps you losemore fat, even when injected,” he said. “Onthe contrary, the published studies showedthat when compared to saline, there was noimprovement with hCG.”

Eastman notes that that is not what they’veseen in their practice. “The hCG helps patientsburn their stored fat,” she said, with Primackstating that patients burn fat because of thesmall amount of calories consumed each day.

And finally...As with most everything related to yourhealth, experts advise that you consult withyour primary care physician before startingon a weight loss plan.

Continued from coverDIETDECISIONS

Karla Birkholz makes no bones aboutthe importance of good nutrition and

exercise in warding off osteoporosis, whichis a skeletal disease characterized by thedeterioration of bone tissue.

“Osteoporosis is very scary,” saidBirkholz, the wellness medical director ofthe John C. Lincoln Physicians Network.“It’s painful and deforming and cancause death, so it’s an important thing toprevent. In fact, more women die from hipfractures related to osteoporosis than frombreast cancer.”

Bone thinning factorsAccording to the American Academy ofFamily Physicians (aafp.org), one in twowomen and one in five men will sustain anosteoporotic fracture after the age of 65.

Birkholz said bone thinning usuallybecomes a problem after menopause,between the ages of 45 and 55. “At thatpoint we are trying to stop the loss ofbone,” she said.

Multiple factors contribute toosteoporosis. Some people were inactivein their youth and didn’t gain the properamount of bone, sometimes genetics area factor, while other times, medicine suchas steroids or cortisone can impact bonehealth. Surprisingly, smoking can alsocontribute to a lack of bone strength.

Battling bone lossJohn Kearney, M.D., a specialist innon-surgical sports medicine at The COREInstitute, recommends that people followgood nutrition and good exercise habits(30 to 60 minutes a day) to slow and evenstop the loss of bone in the body.

ReverseosteoporosisExercise and nutrition put the brakes on bone lossBY DOLORES TROPIANO

Resources“BEST Exercise Program forOsteoporosis Prevention” (abook developed by a Universityof Arizona research team): pubs1.cals.arizona.edu/sales/order.cfm

National Institutes of HealthOsteoporosis and RelatedBone Diseases NationalResource Center: niams.nih.gov/Health_Info/Bone

A bone density test, atype of X-ray, is used tocalculate bone strength.It is often recommendedfor post-menopausalwomen to obtain abaseline assessmentof bone density health.

ResourcesDr. Eastman: jcl.com/physician-network/practices/care-for-women-north-mountain/physicians

Dr. Galper: poweroverfood.com

Jenny Craig: jennycraig.com

Medifast:medifast1.com

Nutrisystem: nutrisystem.com

Optifast: optifast.com

ScottsdaleWeight Loss Center:scottsdaleweightloss.com

WeightWatchers:weightwatchers.com

AHealthierWeighFor patients with a large amountof weight to lose, one option is“A Healthier Weigh,” a weightreduction program designed andformulated by Sophia Fountis,D.O., of Scottsdale. Fountis, whodid M.D. training at the ClevelandClinic, offers what she refers to as “aunique normal-protein diet with nocarbs and no fats.” When following“A Healthier Weigh,” patients eat anindividually prescribed amount oflean protein plus a limited amountof low-carbohydrate vegetables.

Medically tailored to each individual,Fountis offers patients a promise:“Men will lose on average 0.8 poundsper day, while women will lose onaverage 0.5 pounds per day. I offerthat promise whether someone has30 pounds to lose or 500.” Becauseof the diet’s restrictions, patients arerequired to be medically supervised,have blood-work done every twoweeks and also to visit with Fountisevery two weeks. More info:chiro-medcenters.com.

—Paula Hubbs Cohen

Calcium-rich foods• Beans, legumes• Chinese cabbage or bok choy• Dairy products• Green leafy vegetables• Nuts• Shrimp• Tofu• Tortillas

ag yuctsy vegetables

“Any form of weight-bearing exerciseincluding walking, running and/or jumpingwill increase bone mass,” Kearney said.“Resistance training such as light weighttraining, exercise bands, free weightsor weight machines are great.”

One of the simplest things that peoplecan do right at home, he said, is to workwith free weights or use an exercise ball.

Diet and supplementsKearney explained that 1,200 milligramsof calcium citrate are recommendeddaily past the age of 50, plus 400 units ofvitamin D. The body can only absorb 500milligrams of calcium at a time, so anysupplements should be taken accordinglythroughout the day.

Kearney and others are reluctant torecommend additional supplements in lieuof the right foods.

“I firmly believe that it’s difficult tosupplement your way to optimal health,”Kearney said. “All of these nutrients,vitamins and minerals work much betterif you get them in your diet from theirnatural food sources.”

January 2, 2013 | LIVING WELL A-Z | 3

All groups and events are believed,but not guaranteed, to be free unlessotherwise stated. Every effort has beenmade to verify accuracy, but please callbefore attending to confirm details.

WELLNESS

BARIATRIC MEETINGSVarious dates & timesBanner Gateway1900 N. Higley Rd., Gilbert480-543-2606

MINIMALLY INVASIVESPINE SURGERYVarious dates, times & locationsBy Laser Spine InstituteRegister: spineseminar.com;866-811-3275

TOTAL JOINT REPLACEMENTJan. 9, 16, 23 & 30, 9 a.m.Banner Gateway1900 N. Higley Rd., Gilbert602-239-2273

EAT REAL & LOCAL ON A BUDGETJan. 9, 1–2 p.m.By Scottsdale Healthcareat Appaloosa Library7377 E. Silverstone Dr., ScottsdaleRegister: shc.org/events; 480-882-4636

BOOST YOURMEMORYJan. 10, 1–2 p.m.By Scottsdale Healthcareat Civic Center Library3839 N. Drinkwater Blvd., ScottsdaleRegister: shc.org/events; 480-882-4636

NEUROPATHY:DIAGNOSIS & TREATMENTJan. 16, 7–8 p.m.By Scottsdale Healthcareat Barnes & Noble10500 N. 90 St., ScottsdaleRegister: shc.org/events; 480-882-4636

TOBACCO CESSATION PROGRAMJan. 17, 5–6 p.m.Scottsdale Healthcare Osborn7301 E. Fourth St., ScottsdaleRegister: shc.org/events; 480-882-5761

MAKOPLASTYJan. 17, 6 p.m.Arrowhead Hospital18701 N. 67 Ave., GlendaleRegister: azhealthyhours.com;855-292-9355

TOBACCO CESSATION SUPPORTJan. 17, 6–7 p.m.Scottsdale Healthcare Osborn7301 E. Fourth St., ScottsdaleRegister: shc.org/events; 480-882-5761

NEUROPATHY OF THE FEETJan. 22, noon–1 p.m.Mountain VistaMedical Center1301 S. Crismon Rd., MesaRegister: 877-924-9355

BLADDER HEALTHJan. 24, 1–2 p.m.By Scottsdale Healthcareat Civic Center Library3839 N. Drinkwater Blvd., ScottsdaleRegister: shc.org/events; 480-882-4636

HEART/STROKE

CONGESTIVE HEART FAILUREJan. 9, 16, 23 & 30, 6:30–7:30 p.m.Chandler Regional1955W. Frye Rd., Chandler480-728-5414

STROKE SUPPORTJan. 10, 10 a.m.Banner Thunderbird5555W. Thunderbird Rd., Glendale602-865-5450

STROKE SUPPORTJan. 10, 1:30–3 p.m.Banner Baywood6644 E. Baywood Ave., Mesa480-321-4790

STROKE SURVIVORJan. 10, 2:30–4 p.m.Chandler Regional1955W. Frye Rd., Chandler480-728-5414

HEART-HEALTHY EATINGJan. 15, 11 a.m.Banner Heart Hospital6750 E. Baywood Ave., Mesa480-854-5401

STROKE CAREGIVERJan. 24, 2:30–3:30 p.m.Mercy Gilbert3420 S. Mercy Rd., Gilbert480-728-5414

STROKE SCREENINGJan. 28, 8–10 a.m.St. Joseph’s7727W. Deer Valley Rd., PeoriaRegister: 877-602-4111

LIVINGWITH HEART DISEASEJan. 28, noon–1 p.m.Mountain VistaMedical Center1301 S. Crismon Rd., MesaRegister: 877-924-9355

STROKE SUPPORT GROUPJan. 29, 3–4 p.m.Mountain VistaMedical Center1301 S. Crismon Rd., MesaRegister: 877-924-9355

DIABETES

DIABETES SUPPORTCardon Children’s Medical Center1400 S. Dobson Rd., MesaCall for dates & times: 480-412-4557

DIABETES SUPPORT GROUPJan. 10, 1–2 p.m.St. Luke’s Medical Center1800 E. Van Buren St., PhoenixRegister: 877-351-9355

DIABETES SUPPORT GROUPJan. 14, 3–4 p.m.Mountain VistaMedical Center1301 S. Crismon Rd., MesaRegister: 877-924-9355

DIABETES SUPPORTJan. 15, 3–4 p.m.Banner Baywood6644 E. Baywood Ave., Mesa480-321-4578

ALZHEIMER’S/DEMENTIA

COMPASS FOR CAREGIVERSVarious dates & timesBanner Alzheimer’s Institute901 E.Willetta St., PhoenixRegister: [email protected];602-839-6850

KNOW THE 10 SIGNSVarious dates, times & locationsBy Alzheimer’s Association602-528-0545

CAREGIVER SUPPORTJan. 7, 3–4:30 p.m.Banner Estrella9201W. Thomas Rd., Phoenix602-528-0545

CAREGIVERS (DUET)Jan. 8 & 22, 12:30–2 p.m.Church of the Beatitudes555W. Glendale Ave., Phoenix602-274-5022

CAREGIVERS SUPPORTJan. 28, 1:30–3:30 p.m.Banner Sun Health Research10515W. Santa Fe Dr., Sun City623-832-5328

SENIORS

GRANDPARENTS RAISINGGRANDCHILDREN (DUET)Various dates, times & locations602-274-5022

HEARING SCREENINGSJan. 25, 1–4 p.m.Tempe St. Luke’s1500 S. Mill Ave., TempeRegister: 877-351-9355

FLU BASICSJan. 31, noon–1 p.m.Mountain VistaMedical Center1301 S. Crismon Rd., MesaRegister: 877-924-9355

Take advantage of dozens of opportunities for youto meet others with similar issues and learn moreabout various aspects of your health – from A to Z.

Please call to confirm reservationsand cost (if any).

Jan. 11Finding a cure forAlzheimer’s DiseaseWHAT: This GPS (Giving PeopleStrategies for Memory) lecture bythe Banner Alzheimer’s Institutefocuses on Alzheimer’s research,progress and more.WHERE:Musical InstrumentMuseum, 4725 E. Mayo Blvd.,PhoenixTIME: 10:30 a.m.–noonCOST: FreeREGISTER: 602-230-2273

January

TOP Events

Jan. 11Guardianship Clinic(Duet)WHAT: Learn how to become thelegal guardian to grandchildren.This free clinic goes over thenecessary paperwork as wellas the legal process fordetermining custody.WHERE: Church of theBeatitudes, 555W. Glendale Ave.,PhoenixTIME: 3–5 p.m.COST: FreeREGISTER: 602-274-5022, ext. 44

Jan. 22Heart-Healthy EatingWHAT: This seminar focuseson ways to take care of yourheart through proper dietand nutrition.WHERE: Banner Boswell MedicalCenter, 13180 N. 103 Dr., Sun CityTIME: 9:30 a.m.COST: FreeINFO: 602-230-2273

THINKS

TOCK

• Flat soled/hard rubber shoes:ideal for weight lifting and strengthtraining

• Trail/hiking shoes: best for hikingand other outdoor activities

• Running shoes: meant for front-to-back motion (i.e., running andwalking), not side-to-side motionlike in other sports

• Specialty shoes: good forspecialized sports and activities,such as soccer cleats, etc.

Wear and tearPrescott recommended that thelifespan of a shoe should be 400miles or one year — whichever comesfirst. For serious athletes, Shinoskiesuggested changing your shoes everythree months.

Both also advised to wear your shoesonly for their prescribed activity; ithelps the footwear to last longer andis easier on your feet.

Jim Prescott, a training specialist atthe Runner’s Den in Phoenix, joked

that there are three things in life thatyou should never skimp on: mattresses,vacations — and shoes. That’s because,according to Prescott, a good pair of shoescan prevent a lot of unneeded injuries.

Stephen Geller, DPM, FACFAS, thedirector of podiatry at Maricopa MedicalCenter, agreed, since many of the patientshe sees have injuries that could have beenprevented with better footwear.

“When it comes to addressing foot pain,finding the proper shoe is a great placeto start,” Geller said.

Supporting factsOne of the main differences amongvarious types of athletic footwear isthe level of support the shoes offer,Geller noted.

He said there are four main supporttypes: motion control, stability, neutraland cushioning. The level of support youneed depends on your chosen activityand foot care needs.

Garrett Shinoskie, the director ofathletic performance at Zone AthleticPerformance in Scottsdale, added thatpeople need to consider “what shoeis right for what activity.”

Categories of fitness shoesShinoskie and Prescott agreed thatsome of the most popular categoriesof fitness shoes include:• Cross training shoes: great for any

activity that includes multidirectionalmovement

A total shoe-inHow to find the perfect shoe for any fitness activityBY MICHELLE TALSMA EVERSON

The right fit• After one hour of running,

the average foot swells a halfshoe size. After two hours, feetcan swell up to a size bigger.Therefore, buy a full size biggerfor marathons and other similarstrenuous activities.

• Tap your heel at the back of theshoe and make sure your archlines up with the shoe.

Source:Jim Prescott,Runner’s Den

ResourcesFoot Solutions:footsolutions.com

The Runner’s Den:runnersdenaz.com

Zone Athletic Performance:zoneap.com

“Wearing the propershoe size, which I’destimate 90 percentof people do not, andmaintaining properarch support are afew ways to maintainfoot health.”— Sue Orischak, CPED,

a certified pedorthist withFoot Solutions in Scottsdale


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LUTION

ASK An Expert

Living Well a-z invites readers to submit questions to a panel of healthcare experts. The shortquestions and answers will offer readers a little more information about hot topics in medicine andrefer you to other resources where you can learn more. Responses will also arm you with informationso you know what to ask your own healthcare providers. If you would like your question to beconsidered for the February 6, 2013 issue of Living Well a-z, please write to editor: Paula Hubbs Cohen,[email protected] or c/o The Arizona Republic, 200 E. Van Buren St., CA22, Phoenix, AZ 85004.

HEALTHSOUTH REHABILITATION:healthsouth.com

IRONWOOD CANCER ANDRESEARCH CENTERS:IronwoodCRC.com

JOHN C. LINCOLN HOSPITAL:JCL.com

LASER SPINE INSTITUTE:laserspineinstitute.com

MAYO CLINIC:mayoclinic.com

MERCYGILBERTMEDICALCENTER:MercyGilbert.org

MIRACLE EAR:miracle-ear.com

ABRAZO HEALTH CARE(AZ Heart Institute and AZ Heart,Arrowhead, Maryvale, ParadiseValley, Phoenix Baptist andWestValley hospitals): abrazohealth.com

BANNER HEALTH:bannerhealth.com

BARNET DULANEY PERKINS:goodeyes.com

BARROW NEUROLOGICALINSTITUTE: thebarrow.org

CARDON CHILDREN’S MEDICALCENTER: bannerhealth.com

CHANDLER REGIONAL MEDICALCENTER: ChandlerRegional.org

MOUNTAIN VISTA MEDICALCENTER:mvmedicalcenter.com

NORTHVALLEYPLASTICSURGERY:nvpsaz.com

PHOENIX CHILDREN’S HOSPITAL:phoenixchildrens.com

SCOTTSDALEHEALTHCARE: shc.org

ST. JOSEPH’S HOSPITAL ANDMEDICAL CENTER: stjosephs-phx.org

ST. LUKE’S MEDICAL CENTER,PHOENIX: stlukesmedcenter.com

TEMPE ST. LUKE’S:tempestlukeshospital.com

INFO Online

PARKINSON’S

SUPPORT GROUPS (DUET)Various dates, times & locations602-274-5022

PARKINSON’S DANCEVarious dates, times & locationsByMuhammad Ali Parkinson CenterRegister: 602-406-6903

PARKINSON’S SUPPORTJan. 8, 1–2 p.m.HealthSouth Valley of the Sun13460 N. 67 Ave., Glendale623-878-8800

PARKINSON’SJan. 14, 10–11:30 a.m.Banner Sun Health Research10515W. Santa Fe Dr., Sun City602-942-9008

BREASTFEEDING

NURSING MOMS SUPPORTVarious dates & timesBanner Del E. Webb14502W.Meeker Blvd., Sun CityWest602-230-2273

LACTATIONJan. 7, 14, 21 & 28, 1–2 p.m.Banner Estrella9201W. Thomas Rd., Phoenix623-327-8001

BREASTFEEDINGJan. 8 & 22, 10 a.m.Banner Ironwood37000 N. Gantzel Rd., San Tan Valley480-394-4000

BREASTFEEDINGJan. 10, 17, 24 & 31, 1–2:30 p.m.Banner Desert1400 S. Dobson Rd., Mesa480-412-3035

BREASTFEEDING SUPPORTJan. 21, 6–7:30 p.m.Banner Good Samaritan1111 E. McDowell Rd., Phoenix602-839-3502

PARENTING

POSTPARTUM DEPRESSIONJan. 8, 15, 22 & 29, 10–11:30 a.m.Banner Desert1400 S. Dobson Rd., Mesa480-412-5292

POSTPARTUM SUPPORTJan. 8 & 22, 11 a.m.Banner Thunderbird5555W. Thunderbird Rd., Glendale602-865-5908

NEWBORN PARENTINGJan. 8, 2–3:30 p.m.Banner Baywood6644 E. Baywood Ave., Mesa480-321-4455

PREGNANCY, PARENTING & PLAYJan. 10, 17, 24 & 31, 7–9 p.m.Banner Baywood6644 E. Baywood Ave., Mesa480-321-4455

CIRCLE OF MOTHERSJan. 17 & 31, 5–7 p.m.Banner Estrella9201W. Thomas Rd., Phoenix623-327-4000

PREGNANCY & INFANT LOSSFeb. 4, 7 p.m.Banner Desert1400 S. Dobson Rd., Mesa480-412–3595

WOMEN& CANCER

GYNECOLOGICJan. 8, 5–6:15 p.m.Banner Desert1400 S. Dobson Rd., Mesa480-412-4673

YOUNG WOMEN’S SUPPORTJan. 8, 6:30 p.m.Banner Thunderbird5555W. Thunderbird Rd., Glendale602-865-5450

CANCERSUPPORT

YOGA FOR CANCER PATIENTSVarious dates & timesBanner MD Anderson2946 E. Banner Gateway Dr., Gilbert480-256-4141

COPING WITH CANCERJan. 9 & 22, 6:30 p.m.Banner Thunderbird5555W. Thunderbird Rd., Glendale602-865-5450

LIVING & COPING WITH CANCERJan. 15, 5:30 p.m.Banner MD Anderson2946 E. Banner Gateway Dr., Gilbert480-256-4141

KIDS CAN COPEJan. 15, 7 p.m.Banner Thunderbird5555W. Thunderbird Rd., Glendale602-865-5450

JOURNEY TO WELLNESSJan. 16, 4 p.m.Banner MD Anderson2946 E. Banner Gateway Dr., Gilbert480-256-4141

ORAL, HEAD & NECKJan. 16, 4:30–6:30 p.m.Banner Desert1400 S. Dobson Rd., Mesa480-412–4673

COLORECTALJan. 17, 6 p.m.Banner Thunderbird5555W. Thunderbird Rd., Glendale602-865-5450

ESOPHAGEALJan. 17, 6–7:30 p.m.Banner Good Samaritan1111 E. McDowell Rd., Phoenix602-839-4970

PROSTATEJan. 28, 7–9 p.m.Banner Desert1400 S. Dobson Rd., Mesa480-412-4673

BREAST CANCER

BOSOM BUDDIES SUPPORT GROUPSVarious dates, times & locationsAhwatukee/Chandler: 480-893-8900East Valley: 480-969-4119Scottsdale: 623-236-6616West Valley: 623-979-4279

LEARN AND SUPPORTJan. 9, 5:30 p.m.Banner Good Samaritan1111 E. McDowell Rd., PhoenixRegister: 602-712-1006

SUPPORT GROUPJan. 22, 5–6:15 p.m.Banner Desert1400 S. Dobson Rd., Mesa480-412-4673

TRIPLE NEGATIVEJan. 23, 5:30 p.m.Banner Good Samaritan1111 E. McDowell Rd., PhoenixRegister: 602-712-1006

RESPIRATORY

ASTHMA SUPPORT GROUPCardon Children’s Medical Center1400 S. Dobson Rd., MesaCall for dates & times: 480-412-7902

RESPIRATORYJan. 10, 1:30 p.m.Banner Boswell13180 N. 103 Dr., Sun City623-832-5708

ADDITIONALSUPPORTGROUPS

APHASIAJan. 8 & 22, 10–11 a.m.Banner Boswell13180 N. 103 Dr., Sun City623-972-4263

ESSENTIAL TREMORJan. 8, 3 p.m.St. Joachim& St. Anne Church11625 N. 111 Ave., Sun City623-975-9638

AMPUTEEJan. 8, 6–7 p.m.HealthSouth Valley of the Sun13460 N. 67 Ave., Glendale623-334-5358

PAINJan. 10 & 24, 6–8 p.m.HealthSouth Valley of the Sun13460 N. 67 Ave., Glendale623-334-5437

LARYNGECTOMYJan. 15, 4–5 p.m.Banner Boswell13180 N. 103 Dr., Sun City623-832-5349

VESTIBULARJan. 17, noonBanner Good Samaritan1111 E. McDowell Rd., Phoenix602-839-2317

MEN’S DISABILITY ISSUESJan. 17, 5:30–7 p.m.Disability Empowerment Center5025 E.Washington St., Phoenix602-980-3232; [email protected]

OSTOMYFeb. 3, 2–4 p.m.Banner Boswell13180 N. 103 Dr., Sun City623-935-7514

CAREGIVERS

SUPPORT GROUPS (DUET)Various dates, times & locations602-274-5022

ONLINE NETWORKING (DUET)Jan. 12 & 22, 9–10 a.m.Register: duetaz.org (Events tab)602-274-5022

CAREGIVER SUPPORT (DUET)Jan. 31, 8:30 a.m.–3 p.m.Church of the Beatitudes555W. Glendale Ave., Phoenix602-274-5022

BEHAVIORALHEALTH

‘ANONYMOUS’ MEETINGSObsessive-Compulsive; Alcoholics;Al-Anon; Cocaine; Heroin; DepressionVarious dates & timesBanner Behavioral Health7575 E. Earll Dr., ScottsdaleInfo: bannerhealth.com

AL-ANON &ALCOHOLICS ANONYMOUSJan. 5, 12, 19 & 26, 7 p.m.Banner Thunderbird5555W. Thunderbird Rd., GlendaleInfo: bannerhealth.com

Question:What are gallstones?ANSWER: Gallstones developinside the gallbladder which is asmall organ on the right side of theabdomen that stores and releasesbile to help digest fats. Gallstonesformwhen bile hardens into one ormore stone-like deposits.There are twomain types of

gallstones: cholesterol predominantstones and pigment stones.Mixed-type stones (cholesteroland pigment) are also common.Cholesterol gallstones are themost common and, as their namesuggests, are primarily made upof cholesterol deposits. Pigmentgallstones are the result of excessbilirubin in an individual’s bile.Many people go through life

unaware they have gallstonesas they do not experience anynoticeable symptoms.Whengallstones do not cause symptoms,there is usually no need to treatthem. Symptoms can occur when agallstone gets lodged in and blockseither the cystic duct or bile ducts. Ifthis occurs, people often experiencesymptoms such as sudden and/orintermittent pain in the upper rightpart of the abdomen, increasing painbelow the breast bone in the centerof the abdomen, pain between theshoulder blades, and right shoulderpain. Pain can last from a fewminutes to several hours.If symptoms occur, it’s generally

recommended that the gallbladder

be surgically removed, a procedureknown as cholecystectomy,which inmost cases is performedlaparoscopically (aminimallyinvasive procedure). There are alsomedications available that aredesigned to dissolve gallstones, butthese are not used very often as theyare either ineffective, or may takemonths or even years to work.NOOMANGILANI, M.D., FACG,AGAF, IS THE CHAIRMANOF THEGASTROENTEROLOGY DEPARTMENTAT BANNER THUNDERBIRDMEDICALCENTER IN GLENDALE

Question:What isLewybodydementia?ANSWER: Lewy body dementia,the secondmost common typeof progressive dementia afterAlzheimer’s disease, causes aprogressive decline inmentalabilities. In Lewy body dementia,abnormal round structures calledLewy bodies develop in regions ofthe brain involved in thinking andmovement. The diseasemay causevisual hallucinations, whichmaytake the form of seeing shapes,colors, people or animals that aren’tthere or, more complexly, havingconversations with deceasedloved ones.Another indicator may be

significant fluctuations in alertnessand attention, whichmay includedaytime drowsiness or periods ofstaring into space. Like Parkinson’s

disease, Lewy body dementia canresult in rigidmuscles, slowedmovement and tremors.There’s no cure for Lewy body

dementia, instead, doctors treatthe symptoms. Medications suchas those used for Alzheimer’sdisease work by increasing thelevels of neurotransmitters—chemical messengers believedto be important for memory,thought and judgment— inthe brain. This can help improvealertness and cognition, andmay help reduce hallucinationsand other behavioral problems.Parkinson’s diseasemedicationscan help reduce Parkinson’s-likemuscular symptoms insome people, but they can alsocause increased confusion,hallucinations and delusions.Antipsychotic medicationsmay

somewhat improve delusionsand hallucinations, however, atleast a third of the people whohave Lewy body dementia havea dangerous sensitivity to someof these types of drugs. Becauseantipsychotic drugs canworsenthe symptoms, it might bebetter to initially try non-drugapproaches, such asmodifyingthe environment, modifyingcaregivers’ responses and/ormodifying tasks.BRYANWOODRUFF,M.D.,IS A NEUROLOGIST ATMAYO CLINICIN ARIZONA

WEDNESDAY, January 2, 2013 | LIVING WELL A-Z | 5

Join us for free healthassessments and tours ofBanner Children’sMobile Health Clinic

plus snacks and other fun activities.

Banner Ironwood Medical CenterSaturday, January 1910:00 a.m.- 1:00 p.m.

Banner Estrella Medical CenterSaturday, January 2610:00 a.m.- 1:00 p.m.

FREEHEARING TEST

26 Arizona Locations

Call 602-814-0072www.Miracle-Ear-Phoenix.com

Not a medical exam.Audiometric testto determine proper amplification needs only.Good only from participating Miracle-Earproviders. See store for details.

I taught my children to nevergive up. After my breast cancerdiagnosis, I followed my ownadvice and got a second opinion.My answer was Mayo Clinic.

Kim Loving

Kim had an entire team of world-renowned Mayo Clinic Cancer Center experts focused on herrecovery. If you are diagnosed with breast cancer, you deserve the best as well. Mayo Clinicpatients with breast cancer have substantially higher five-year survival rates compared to theU.S. National Cancer Database. We are an in-network provider for most people and a physicianreferral is rarely required. To schedule an appointment, call (480) 301-8000 or call our BreastClinic directly at (480) 301-4000.

Visit mayoclinic.org/breastcancer

BARIATRIC PROGRAMHear aboutmedical& surgical

treatments for obesity.

THURS., JAN 10:6-6:45PM

TUES., JAN 22:6-6:45PM

(480) 301-4533MayoClinic.org/Arizona

Diet and stressAlthough migraines have been around forcenturies, both Mittman and McGinley saydoctors are just starting to understandthem. And if food is thought to be a maintrigger, stress is right up there, too, theyboth said. For that reason, McGinleysuggests investing in “yoga or someother exercise that teaches relaxationtechniques,” like Tai Chi, since mild exerciseis thought to mitigate migraines.While it’s important to speak with your

primary care provider before consideringany new treatment, Mittman saidcomplementary approaches to standardmedical treatment may include:• Decreasing inflammation in the diet bydecreasing fats

• Stress management techniques, chieflyexercise or biofeedback

• Acupuncture• “Mindful meditation” (Mittmansuggests visiting umassmed.edu/cfmto learn more)

• Spinal manipulation• Herbs, namely Feverfew (Tanacetum

parthenium) and Butterbur (Petasitesvulgaris), which may reduce frequencyof headaches, but should not be takenby pregnant women

Migraine headache sufferers’ pain isoften confined to the area of the

head, but experts think it could be whatfolks put in their mouth— and how theytreat the rest of their bodies, especially inregard to relaxation and exercise— that canplay a role in these incapacitating episodes.“We can control a lot by what we eat,”

said Denise McGinley, R.N., M.S.N.Ad.,director of the Center for OrthopaedicInnovation at St. Luke’s Medical Center inPhoenix, “and food is a big culprit whenit comes to migraines.”Proper food and drink intake is key, she

added, because being dehydrated is linkedto increased headaches, while skippingmeals also makes one more susceptible.McGinley recommends keeping a fooddiary to try and detect if a food allergyor a combination of two or more foodsis causing an issue.

Excruciating painOverall, about 12 percent of the populationsuffers frommigraines, said Paul Mittman,N.D., Ed.D., president and CEO of theSouthwest College of NaturopathicMedicineand Health Sciences in Tempe, and thepain they deal with is often excruciating. Infact, he describes a migraine as “a vascularand electromagnetic firestorm inside thebody,” one that usually includes a pulsatingor throbbing sensation in the head,sometimes so painful it’s “blinding.”

Many people report amigraine startingon one side of the head andmoving tothe other side. About a quarter of sufferersalso experience a visual “aura” or what’sbeen referred to as a premonition that aheadache’s about to occur. This can becommonly experienced as spots, “shootingstars” or flecks of light in the peripheralvision. Nausea and vomitingmay also occur,“which somepeople find as debilitating asthe pain itself,” Mittman said. Sufferersmightalso be sensitive to light, sound or touch.

Hope formigraine sufferersHow to keep a ‘vascular and electromagnetic firestorm’ at bay BY GREMLYN BRADLEY-WADDELL

ResourcesAmerican Headache Society:americanheadachesociety.org

AmericanMigraine Foundation:americanmigrainefoundation.org

Southwest College of NaturopathicMedicine and Health: scnm.edu

St. Luke’s Center for OrthopaedicInnovation: stlukesmedcenter.com

Some commonmigraine triggers:• cheese, particularly aged varieties• processed luncheon meats• nuts• foods containing MSG(monosodium glutamate)

• cold foods• alcohol

“While no one knowsexactly what causesmigraines, genetics isoften a cause and up to90 percent of sufferershave a family history.”— Denise McGinley, R.N., M.S.N.Ad.

THINKS

TOCK


EXPERTS

Frank Fara, M.D.

Like his father and grandfather before him,Dr. Fara is dedicatedto women’s health and wellness.He is certified by theAmericanBoard of Obstetrics & Gynecology and is affiliated with theAmerican College of Obstetricians and Gynecologists.Dr. Fara is a graduate of the Southern Illinois University Schoolof Medicine.He completed an internship and residency atBayside Medical Center in Springfield,Mass.

GYNECOLOGY/OBSTETRICS

Banner Health CenterSpecializing in Obstetrics and Gynecology13995 W. Statler Blvd., Surprise623.478.3100 • www.BannerHealth.com/HealthCenterSurprise

David Forest, M.D.

With a commitment to providing the most reliable informationand treatment options,Dr. Forest is dedicated to serving womenin the northwestValley. He is certified by theAmerican Board ofObstetrics & Gynecology and is affiliated with theAmerican Collegeof Obstetricians and Gynecologists.

Dr. Forest is a graduate of Rosalind Franklin University of Medicineand Science in Chicago, Illinois and completed an internship andresidency at Naval Medical Command in Oakland,California.Hespecializes in full pregnancy care, general gynecological evaluation andtreatment, minimally invasive gynecological procedures and surgery.



Teresa Malcolm, M.D.

With a sincere belief that each woman has unique needsand deserves compassion and respect,Dr.Malcolm worksto provide clear explanations of tests, diagnoses and therapies.

A graduate ofTulane University School of Medicine, shecompleted an internship at University of California, LosAngeles;a family practice residency atAdvocate Christ Medical Centerat University of Illinois; and an obstetrics and gynecologyresidency at Phoenix Integrated Residency.



LivingWellAZ-Jan.2013

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